Retrocrural Lymph Node Metastasis Disclosed by 18F-FDG PET/CT: A Predictor of Supra-diaphragmatic Spread in Ovarian Cancer

Purpose

Retrocrural lymph nodes (RCLNs) communicate with retroperitoneal and posterior mediastinal LNs. It is possible that, when RCLNs are involved, supra-diaphragmatic extension will occur in abdomino-pelvic cancers. The authors investigated performance of ¹⁸F-FDG PET/CT to diagnose RCLN metastasis and whether RCLN metastases were associated with supra-diaphragmatic lymphatic metastases of ovarian cancer.

Materials and methods

Sixty-seven patients with stage IV ovarian cancer who had undergone ¹⁸F-FDG PET/CT were included in this retrospective study. Diagnostic performance of ¹⁸F-FDG PET/CT for RCLN metastasis was evaluated. Patients were divided into two groups by presence or absence of supra-diaphragmatic LN metastasis. The prevalences of RCLN metastasis between the two groups were compared and the odds ratio was calculated.

Results

Sensitivity and specificity of ¹⁸F-FDG PET/CT for RCLN metastasis were 96.3 and 100%, respectively. Of the 67 study subjects, 27 patients had RCLN metastases (40.3%). Fifty patients had supra-diaphragmatic LN metastases. ¹⁸F-FDG PET/CT showed 26 RCLN metastases in patients with supra-diaphragmatic LN metastases (54.5%), and only 1 in patients without supra-diaphragmatic LN metastasis (5.9%), and the difference between two groups was statistically significant (P < 0.05). The odds ratio that patients with RCLN metastasis would have supra-diaphragmatic LN metastasis was 17.3 (95% confidence interval = 2.1 to 140.9, P = 0.008).

Conclusion

Performance of ¹⁸F-FDG PET/CT to diagnose RCLN metastasis was excellent. RCLN metastasis revealed by ¹⁸F-FDG PET/CT was strongly associated with supra-diaphragmatic LN spread of ovarian cancer. Thus, RCLN metastasis could be used as a predictor of supra-diaphragmatic lymphatic metastasis of ovarian cancer.     

(18)F-FDG PET versus (18)F-FDG PET/CT for adrenal gland lesion characterization: a comparison of diagnostic efficacy in lung cancer patients.

OBJECTIVE: The aim of this study was to assess the diagnostic efficacy of integrated PET/CT using fluorodeoxyglucose (FDG) for the differentiation of benign and metastatic adrenal gland lesions in patients with lung cancer and to compare the diagnostic efficacy with the use of PET alone. MATERIALS AND METHODS: Sixty-one adrenal lesions (size range, 5-104 mm; mean size, 16 mm) were evaluated retrospectively in 42 lung cancer patients. Both PET images alone and integrated PET/CT images were assessed, respectively, at two-month intervals. PET findings were interpreted as positive if the FDG uptake of adrenal lesions was greater than or equal to that of the liver, and the PET/CT findings were interpreted as positive if an adrenal lesion show attenuation > 10 HU and showed increased FDG uptake. Final diagnoses of adrenal gland lesions were made at clinical follow-up (n = 52) or by a biopsy (n = 9) when available. The diagnostic accuracies of PET and PET/CT for the characterization of adrenal lesions were compared using the McNemar test. RESULTS: Thirty-five (57%) of the 61 adrenal lesions were metastatic and the remaining 26 lesions were benign. For the depiction of adrenal gland metastasis, the sensitivity, specificity, and accuracy of PET were 74%, 73%, and 74%, respectively, whereas those of integrated PET/CT were 80%, 89%, and 84%, respectively (p values; 0.5, 0.125, and 0.031, respectively). CONCLUSION: The use of integrated PET/CT is more accurate than the use of PET alone for differentiating benign and metastatic adrenal gland lesions in lung cancer patients.     

Retroperitoneal Bronchogenic Cyst Presenting Paraadrenal Tumor Incidentally Detected by 18F-FDG PET/CT

A follow-up ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) PET/CT scan of a 57-year-old asymptomatic male who had undergone total thyroidectomy for thyroid cancer revealed a 5.0 × 4.0-cm, well-defined, ovoid-shaped mass around the left adrenal gland without definite FDG uptake. On the adrenal CT scan, the left paraadrenal tumor showed high attenuation on the precontrast scan without enhancement. The average Hounsfield unit (HU) was 58.1 on the precontrast scan and 58.4 on the postcontrast scan. The patient underwent laparoscopic adrenalectomy for resection of the left paraadrenal tumor. The final histopathologic examination revealed a bronchogenic cyst. Although retroperitoneal bronchogenic cysts are rare, they should be considered in the differential diagnosis of retroperitoneal cystic tumors. The preoperative diagnosis is difficult, but a contrast-enhanced CT scan or ¹⁸F-FDG PET/CT scan may be useful for differentiating hyperattenuated cysts from other soft tissue masses.     

Primary Malignant Fibrous Histiocytoma in Mediastinum: Imaging with 18F-FDG PET/CT

Malignant fibrous histiocytoma (MFH) is the most common soft tissue tumor which often occurs in the extremities and the retroperitoneum. Primary mediastinal MFH is rare; thus, findings on ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) of mediastinal MFH have not been reported yet. We report herein the case of a 64-year-old man who was presented with a superior mediastinal mass. The mass showed intense ¹⁸F-FDG uptake with central metabolic defect on PET/CT. The maximum standardized uptake value was 17.4. After tumor removal via median sternotomy, an MFH of the storiform-pleomorphic type was diagnosed on histopathologic examination. We present the first report of ¹⁸F-FDG PET/CT imaging of MFH in the superior mediastinum.     

The Clinical Role of Dual-Time-Point 18F-FDG PET/CT in Differential Diagnosis of the Thyroid Incidentaloma

Thyroid incidentalomas are common findings during imaging studies including ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) for cancer evaluation. Although the overall incidence of incidental thyroid uptake detected on PET imaging is low, clinical attention should be warranted owing to the high incidence of harboring primary thyroid malignancy. We retrospectively reviewed 2,368 dual-time-point ¹⁸F-FDG PET/CT cases that were undertaken for cancer evaluation from November 2007 to February 2009, to determine the clinical impact of dual-time-point imaging in the differential diagnosis of thyroid incidentalomas. Focal thyroid uptake was identified in 64 PET cases and final diagnosis was clarified with cytology/histology in a total of 27 patients with ¹⁸F-FDG-avid incidental thyroid lesion. The maximum standardized uptake value (SUVmax) of the initial image (SUV1) and SUVmax of the delayed image (SUV2) were determined, and the retention index (RI) was calculated by dividing the difference between SUV2 and SUV1 by SUV1 (i.e., RI = [SUV2 - SUV1]/SUV1 × 100). These indices were compared between patient groups that were proven to have pathologically benign or malignant thyroid lesions. There was no statistically significant difference in SUV1 between benign and malignant lesions. SUV2 and RI of the malignant lesions were significantly higher than the benign lesions. The areas under the ROC curves showed that SUV2 and RI have the ability to discriminate between benign and malignant thyroid lesions. The predictability of dual-time-point PET parameters for thyroid malignancy was assessed by ROC curve analyses. When SUV2 of 3.9 was used as cut-off threshold, malignancy on the pathology could be predicted with a sensitivity of 87.5 % and specificity of 75 %. A thyroid lesion that shows RI greater than 12.5 % could be expected to be malignant (sensitivity 88.9 %, specificity 66.3 %). All malignant lesions showed an increase in SUVmax on the delayed images compared with the initial images. But in the group of benign lesions, 37.5 % (6/16) showed a decrease or no change in SUVmax. Dual-time-point ¹⁸F-FDG PET/CT, obtaining additional images 2 h after injection, seems to be a complementary method for the differentiation between malignancy and benignity of incidental thyroid lesions.     

The role of F-FDG PET or PET/CT in the detection of fever of unknown origin

Even with the recent advance in diagnostic tools and techniques, fever of unknown origin (FUO) remains a clinical challenge. A wide range of diseases, mainly infections, autoimmune conditions (inflammatory diseases), malignancies and miscellaneous can cause FUO. Positron emission tomography (PET) or positron emission tomography/computed tomography (PET/CT) scanning makes a great contribution to the diagnosis and differential diagnosis of FUO due to the high sensitivity of pathological accumulation of ¹⁸F-FDG. The diagnostic yield of PET/CT is higher than traditional radiographic imaging and other nuclear medicine scanning. Owing to the numerous advantages of PET/CT including high sensitivity and the ability to perform whole-body scans, many rare diseases presenting with FUO can be detected and the spectrum of diseases that can exhibit FUO has been increasing. Recent studies utilizing FUO are discussed in this paper. However, there are limited data available about the role of ¹⁸F-FDG PET or PET/CT in evaluation of FUO.     

Evaluation of gross tumor size using CT, 18F-FDG PET, integrated 18F-FDG PET/CT and pathological analysis in non-small cell lung cancer

Purpose

The correlation of gross tumor sizes between combined ¹⁸F-FDG PET/CT images and macroscopic surgical samples has not yet been studied in detail. In the present study, we compared CT, ¹⁸F-FDG PET and combined ¹⁸F-FDG PET/CT for the delineation of gross tumor volume (GTV) and validated the results through examination of the macroscopic surgical specimen.

Methods

Fifty-two operable non-small cell lung cancer (NSCLC) patients had integrated ¹⁸F-FDG PET/CT scans preoperatively and pathological examination post-operation. Four separate maximal tumor sizes at X (lateral direction), Y (ventro-dorsal direction) and Z (cranio-caudal direction) axis were measured on ¹⁸F-FDG PET, CT, combined ¹⁸F-FDG PET/CT and surgical specimen, respectively. Linear regression was calculated for each of the three imaging measurements versus pathological measurement.

Results

No significant differences were observed among the tumor sizes measured by three images and pathological method. Compared with pathological measurement, CT size at X, Y, Z axis was larger, whereas combined ¹⁸F-FDG PET/CT and ¹⁸F-FDG PET size were smaller. Combined ¹⁸F-FDG PET/CT size was more similar to the pathological size than that of ¹⁸F-FDG PET or CT. Results of linear regressions showed that integrated ¹⁸F-FDG PET/CT was the most accurate modality in measuring the size of cancer.

Conclusions

¹⁸F-FDG PET/CT correlates more faithfully with pathological findings than ¹⁸F-FDG PET or CT. Integrated ¹⁸F-FDG PET/CT is an effective tool to define the target of GTV in radiotherapy.     

Nonfunctioning endocrine pancreatic tumor examined with 18F-FDG PET/CT

A 71-year-old woman with type 2 diabetes mellitus complained of generalized fatigue. A 36-mm tumor in the pancreatic tail was detected with ultrasonography. The tumor was found to have marked hypervascularity with contrast-enhanced computed tomography (CT) and magnetic resonance. Combined ¹⁸F-fluorodeoxyglucose positron emission tomography and CT (¹⁸F-FDG PET/CT) showed ¹⁸F-FDG by the tumor with a maximal standardized uptake value of 2.98 at 50 min and 3.29 at 100 min following injection of ¹⁸F-FDG. ¹⁸F-FDG PET/CT suggested no extrapancreatic spread of the tumor. The patient had no pancreatic hormone-associated symptoms. Distal pancreatectomy was performed, and a well-differentiated endocrine tumor was diagnosed. The resected specimen showed neither infiltration of adjacent structures nor metastasis to regional lymph nodes. The present case suggests that ¹⁸F-FDG PET/CT is a reliable modality for staging endocrine pancreatic tumors.     

The Prognostic Value of 18F-FDG PET/CT for Early Recurrence in Operable Breast Cancer: Comparison with TNM Stage

Purpose

We evaluated whether the maximum standardized uptake values (SUV_max) of primary tumor from the initial staging by ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) of patients with breast cancer could identify patients at risk for early recurrence within 2 years, particularly in comparison to the American Joint Committee on Cancer (AJCC) stage.

Methods

We reviewed the staging ¹⁸F-FDG PET/CT images of patients with primary breast cancer and their medical records. The SUV_max of the primary tumor was measured. The presence or absence of FDG uptake in the axillary lymph node (ALN) was also assessed. The patient’s pathologic primary tumor stage (pT), pathologic regional lymph node stage (pN), stage grouping, age, estrogen receptor (ER) and progesterone receptor (PR) status, and neoadjuvant chemotherapy history were evaluated with the FDG uptake parameters for recurrence within 2 years following the end of first-line therapy.

Results

Recurrence within 2 years was present in 9.1 % (n = 40) out of the 441 patients assessed. The FDG uptake in ALN, pT, pN, stage grouping and neoadjuvant chemotherapy history were prognostic for early recurrence, while primary tumor SUV_max, age, and ER or PR status were not significant on logistic regression. On multivariate analysis, only the stage grouping (odds ratio 2.79; 95 % CI 1.73, 4.48; p < 0.0001) and neoadjuvant chemotherapy history (odds ratio 2.70; 95 % CI 1.22, 5.98; p = 0.0141) could identify patients at increased risk for recurrence within 2 years.

Conclusions

Primary tumor FDG uptake measured by SUV_max, and visual assessment of FDG uptake in the ALN in the initial staging PET/CT of patients with breast cancer may not have additional prognostic value compared with the AJCC stage grouping for early recurrence.     

Late Port Site Metastasis from Occult Gall Bladder Carcinoma After Laparoscopic Cholecystectomy for Cholelithiasis: The Role of 18F-FDG PET/CT

Late port site metastasis of gall bladder carcinoma (GBC) after laparoscopic cholecystectomy is a rare finding. Rarer still is such a presentation where the GBC remained occult at histopathology. ¹⁸F-flurodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) can play an important role in this setting by supporting the diagnosis of port site metastasis, by demonstrating additional sites of metastasis, if any, and by ruling out any other primary site. We here present two such patients with late port site metastasis of occult GBC after laparoscopic cholecystectomy for cholelithiasis and discuss the role of ¹⁸F-FDG PET/CT in this setting.     

Imaging Findings and Literature Review of 18F-FDG PET/CT in Primary Systemic AL Amyloidosis

Purpose

Although several case reports and case series have described ¹⁸F-FDG PET/CT in amyloidosis, the value of ¹⁸F-FDG PET/CT for diagnosing amyloidosis has not been clarified. We investigated the imaging findings of ¹⁸F-FDG PET/CT in patients with primary systemic AL amyloidosis.

Methods

Subjects were 15 patients (M:F = 12:3; age, 61.5 ± 7.4 years) with histologically confirmed primary systemic AL amyloidosis who underwent pretreatment ¹⁸F-FDG PET/CT to rule out the possibility of malignancy or for initial workup of alleged cancer. For involved organs, visual and semiquantitative analyses were performed on ¹⁸F-FDG PET/CT images. In total, 22 organs (10 hearts, 5 kidneys, 2 stomachs, 2 colons, 1 ileum, 1 pancreas, and 1 liver) were histologically confirmed to have primary systemic AL amyloidosis.

Results

F-FDG uptake was significantly increased in 15 of the 22 organs (68.2 %; 10 hearts, 2 kidneys, 1 colon, 1 ileum, and 1 liver; SUVmax = 7.0 ± 3.2, range 2.1–14.1). However, in 11 of 15 PET-positive organs (78.6 %; 10 hearts and the ileum), it was difficult to differentiate pathological uptake from physiological uptake. Definitely abnormal ¹⁸F-FDG uptake was found in only 4 of the 22 organs (18.2 %; 2 kidneys, 1 colon, and the liver). ¹⁸F-FDG uptake was negative for pancreas and gastric lesions.

Conclusions

Although ¹⁸F-FDG PET/CT showed high uptake in two-thirds of the organs involving primary systemic AL amyloidosis, its sensitivity appeared to be low to make differentiation of pathological uptake from physiological uptake. However, due to the small number of cases, further study for the role of ¹⁸F-FDG PET/CT in amyloidosis will be warranted.     

Small Cell Carcinoma of the Gallbladder: 18F-FDG PET/CT Imaging Features—A Case Report

The diagnostic role of ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography (PET)/computed tomography (CT) for gallbladder small cell carcinoma has not been reported. A knowledge of the imaging characteristic features of this malignancy can be useful. Here we report a rare case of a patient who had various diagnostic imaging modalities, including ¹⁸F-FDG PET/CT.     

Pulmonary Actinomycosis Imitating Lung Cancer on 18F-FDG PET/CT: A Case Report and Literature Review

Here we report a case of 41-year-old man with a soft tissue density mass at right upper lung and palpable abscesses at right upper backside and right wrist. ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography demonstrated a 7.8 × 5.0 cm mass with soft-tissue density in the upper lobe of the right lung with high metabolic activity. The infiltrative mass extended to adjacent chest wall soft tissue. Final diagnosis of pulmonary actinomycosis with multiple abscesses was made. The patient responded well to antibiotics treatment.     

Multifocal Colonic Lesions Detected by 18F-FDG PET/CT: Correlation with Histopathology and Gross Specimen

A 73-year-old man underwent ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) for the staging of colon cancer. The ¹⁸F-FDG PET/CT revealed three colonic lesions. The histopathologic examination of the postoperative gross specimen revealed a tubular adenoma, a tubulovillous adenoma and an adenocarinoma. The maximal standardized uptake value (SUVmax) of a tubulovillous adenoma was much higher than that of adenocarcinoma. This patient could be considered as a representative case highlighting that SUVmax is not a reliable indicator for discriminating colon cancer from colonic adenomas.     

多发性骨髓瘤的18F-FDGPET/CT诊断

目的:多发性骨髓瘤是一种浆细胞恶性增殖性疾病,大约有80％的患者存在骨骼侵犯.本文探讨多发性骨髓瘤的18F-fluorodexoxyglucose(18F-FDG)PET/CT表现特点,提高对多发性骨髓瘤的认识.方法:26例按2001年WHO诊断标准确诊为多发性骨髓瘤的患者,均在治疗前行18F-FDG PET/CT显像.所有患者均依赖骨髓穿刺或活检取得明确病理学诊断.结果:26名患者均出现不同程度的骨质疏松.25例患者出现多发性骨质破坏,占总数的96.2％;其中11例患者出现颅骨破坏,占42.3％;25例出现脊柱骨质破坏,占96.2％;15例出现胸骨骨质破坏,占57.7％;21例出现肋骨骨质破坏,占80.8％;21例出现骨盆骨质破坏,占80.8％.部分骨破坏病灶呈18F-FDG高代谢灶.结论:多发性骨髓瘤的18F-FDG PET/CT表现具有一定特征,结合临床、影像、实验室和病理学检查能提高本病的诊断率.     

Usefulness of <Superscript>18</Superscript>F-FDG PET/CT to Detect Metastatic Mucinous Adenocarcinoma Within an Inguinal Hernia

Metastatic mucinous adenocarcinoma in an inguinal hernia is a rare disease and the image findings of ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography (PET)/computed tomography (CT) are little known. Here, we introduce a 57-year-old man with metastatic mucinous adenocarcinoma in an inguinal hernia. On initial ¹⁸F-FDG PET/CT, hypermetabolism was observed in mucinous adenocarcinoma of the cecum, and adenocarcinomas of the transverse and ascending colon, respectively. Follow-up ¹⁸F-FDG PET/CT revealed newly developed multiple hypermetabolism in peritoneal seeding masses and nodules in the pelvic cavity and scrotum. Peritoneal carcinomatosis in the right pelvic side wall was extended to the incarcerated peritoneum and mesentery in the right inguinoscrotal hernia.¹⁸F-FDG PET/CT was useful to reveal unexpected peritoneal seeding within the inguinal hernia. Also, this case demonstrated that metastatic mucinous adenocarcinomas had variably intense FDG uptake.     

Primary Pulmonary Low-Grade Angiosarcoma Characterized by Mismatch between 18F-FDG PET and Dynamic Contrast-Enhanced CT

We report a rare case of primary pulmonary low-grade angiosarcoma on dynamic contrast-enhanced CT and ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT imaging. A 38-year-old, asymptomatic woman was hospitalized because of an abnormality on chest radiography. A dynamic contrast-enhanced chest CT showed a 1.2 cm-sized irregular-margined nodule with strong and persistent enhancement in the right lower lobe. The lesion had low metabolic activity on an ¹⁸F-FDG PET/CT scan. The patient underwent a wedge resection for the lesion, and pathology revealed a primary pulmonary low-grade angiosarcoma.     

18F-FDOPA与18F-FDG PET/CT诊断脑肿瘤的系统评价

目的 系统评价18F-FDOPA与18F-FDG PET/CT显像在脑肿瘤诊断中的临床价值.方法 采用Meta分析与直接比较方法.使用计算机检索中国期刊全文数据库、中文科技期刊数据库、万方数据库、中国生物医学文献数据库、PubMed、Embase、The Cochrane Library,从建库至2016年10月,搜索直接比较18F-FDOPA与18F-FDG PET/CT诊断脑肿瘤的诊断性试验.用Meta-Disc 1.4软件进行分析,计算两种不同显像剂的合并敏感度(sensitivity,SEN)、合并特异度(specificity,SPE)、合并阳性似然比(positive likelihood ratio,+LR)、合并阴性似然比(negative likelihood ratio,-LR)、诊断优势比(diagnostic odds ratio,DOR),并绘制综合受试者工作特征曲线计算曲线下面积(area under curve,AUC)与Q*值.结果 最终共纳入4篇文章,Meta 分析结果显示,18F-FDOPA PET/CT对脑肿瘤诊断的合并SEN为0.97(95％ CI =0.90 ～ 1.00),SPE为0.67(95％ CI =0.45 ～0.84),+LR为2.31 (95％ CI=1.40 ～3.81),-LR为0.07 (95％ CI =0.02～ 0.24),DOR为39.72(95％ CI=8.94～176.48),AUC为0.9725,Q*为0.9239.18F-FDG PET/CT对脑肿瘤诊断的合并SEN为0.51(95％CI=0.39～0.63),SPE为0.75(95％ CI=0.53 ～0.90,+LR为l.59(95％ CI=0.70 ～ 3.61),-LR为0.63(95％ CI =0.47 ～0.86),DOR为2.55(95％ CI =0.82 ～7.92),AUC为0.5848,Q*为0.5638.结论 18F-FDOPA PET/CT显像诊断脑肿瘤的敏感性比18F-FDG高,对脑肿瘤具有良好的诊断价值,可作为脑肿瘤诊断的方法之一.     

Prognostic Significance of Volume-based Metabolic Parameters by 18F-FDG PET/CT in Gallbladder Carcinoma

Purpose

We investigated the prognostic values of volume-based metabolic parameters by ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography (PET)/computed tomography (CT) in gallbladder carcinoma patients and compared them with other prognostic parameters.

Materials and Methods

We enrolled 44 patients, who were initially diagnosed with gallbladder carcinoma and undergoing ¹⁸F-FDG PET/CT. Various metabolic volume-based PET parameters of primary tumors, including maximum and average standardized uptake values (SUV_max, SUV_avg), metabolic tumor volume (MTV), and total lesion glycolysis (TLG), were measured in gallbladder carcinoma patients using mediastinal blood pool activity as a threshold SUV for determining the tumor boundaries. Overall survival analysis was performed using the Kaplan-Meier method with PET parameters and other clinical variables. For determining independent prognostic factors, Cox proportional hazards regression analysis was performed.

Results

Of the 44 enrolled patients, cancer- or treatment-related death occurred in 30 (68.2 %). The mean clinical follow-up period was 22.2 ± 10.4 m (range, 0.6-35.9 m). Univariate analysis demonstrated that clinical or pathologic TNM stage (P < 0.001), treatment modality (P < 0.001), MTV (cutoff = 135 cm³, P = 0.001), and TLG (cutoff = 7,090, P < 0.05) were significant prognostic factors. In multivariate analysis, both clinical or pathologic TNM stage [hazard ratio (HR) = 2.019 (I vs II), 21.287 (I vs III), and 24.354 (I vs IV); P = 0.001) and TLG (HR = 2.930; P < 0.05) were independent prognostic factors for predicting overall survival.

Conclusions

In gallbladder cancer, TLG of the primary tumor, a volume-based metabolic parameter, is a significant independent prognostic factor for overall survival in conjunction with the clinical or pathological TNM stage.     

18F-FDG PET/CT in Primary AL Hepatic Amyloidosis Associated with Multiple Myeloma

We report here on a rare case of primary AL hepatic amyloidosis associated with multiple myeloma in a 64-year-old woman. The patient was referred for evaluating her progressive jaundice and right upper quadrant pain. ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography (PET)/computed tomography (CT) showed diffusely and markedly increased ¹⁸F-FDG uptake in the liver. Although there have been several case studies showing positive ¹⁸F-FDG uptake in pulmonary amyloidosis, to the best of our knowledge, the ¹⁸F-FDG PET/CT findings of hepatic amyloidosis or primary hepatic amyloidosis associated with multiple myeloma have not been reported previously.